Provider Demographics
NPI:1114904109
Name:WENDT, ALBERT GUY (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:GUY
Last Name:WENDT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3030 N CENTRAL AVE STE 1001
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2716
Mailing Address - Country:US
Mailing Address - Phone:602-406-4786
Mailing Address - Fax:916-636-4358
Practice Address - Street 1:625 N 6TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-2155
Practice Address - Country:US
Practice Address - Phone:602-406-8222
Practice Address - Fax:602-406-7811
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2019-07-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ9237207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD00547Medicare UPIN